Bowel sounds are the rumbling or gurgling noises, that are produced when fluid or gas moves through the intestine. Wave-like muscle contractions, known as peristaltic movement, is responsible for moving foods and gases through the digestive tract. This produces the rumbling bowel sound, which is also known as 'borborygmus'. Bowel sounds are usually normal and can be heard with the help of a stethoscope. They simply indicate that the gastrointestinal tract is working.
Sometimes bowel sounds can be loud enough to be heard without a stethoscope as well. Such hyperactive bowel sounds typically indicate an increase in intestinal activity. On the other hand, hypoactive or reduced bowel sounds can indicate a decline in intestinal activity. If bowel sounds are present with some other symptoms like, gas, nausea, vomiting, and presence or absence of bowel movements, then they may indicate certain underlying diseases or disorders. Absence of bowel sounds after a period of increased bowel sounds, can be a matter of serious health concern, as it may indicate rupture of the intestine, or strangulation of the bowel with subsequent death (necrosis) of the bowel tissue.
Causes of Abnormal Bowel Sounds
It is quite normal to hear the rumbling sound of bowel stimulation after eating or when we are hungry. But, abnormal bowel sounds may be associated with certain health conditions, especially if these are followed by no or hypoactive bowel sounds. Some of the possible causes of abnormal bowel sounds are explained below.
Diarrhea is characterized by loose and watery stool, and is most often caused by bacterial infections and intake of certain medications. Diarrhea usually lasts for a couple of days and then subsides. However, persistent diarrhea, along with fever, vomiting, and the presence of blood and mucus in the stool, calls for immediate medical attention.
Crohn's disease is a type of inflammatory bowel disease (IBD), which causes inflammation of the gastrointestinal tract. The inflammation normally affects the intestine, but can also occur anywhere from the mouth to the rectum or anus. Related signs or symptoms include, diarrhea, vomiting, abdominal pain and cramping, a low-grade fever, blood in stool, abdominal distention or tenderness, and feeling of a mass in the abdomen.
Ulcerative colitis is another kind of inflammatory bowel disease (IBD), that causes inflammation of the large intestine and rectum. It usually affects the innermost lining of the large intestine and rectum. This condition can produce several symptoms, such as bloody diarrhea, vomiting, anorexia, fever, abdominal pain, nausea, and tenesmus, along with increased abdominal sounds.
Gastroenteritis refers to the irritation and inflammation of the gastrointestinal tract, which can be caused by bacterial or viral infections. It usually occurs by eating or drinking foods contaminated with bacteria, viruses or parasites. The microorganisms settle in the small intestine, and cause inflammation and swelling, which can lead to abdominal pain, cramping, bowel sounds, nausea, vomiting, a low-grade fever, diarrhea, and dehydration. Sometimes, gastroenteritis may also be associated with excessive use of certain medications, like steroids and non-steroidal anti-inflammatory drugs.
Both food allergy and food intolerance can cause increased bowel sounds. Food intolerance usually occurs, when the body does not produce an adequate amount of the particular type of chemical or enzyme, required to digest the specific food. On the other hand, food allergy is caused by an abnormal reaction of the immune system to a particular food.
Another cause of abnormal bowel sounds is GI hemorrhage, which refers to bleeding of the gastrointestinal tract. The severity of bleeding may range from undetectable to acute, massive, and even life-threatening. Abdominal sounds, along with hematemesis (vomiting up blood), coffee-ground vomitus, dark or tarry stool, abdominal distention, bloody diarrhea, etc., are the most prominent indicators of persistent GI bleeding or hemorrhage.
Mechanical Intestinal Obstruction
Mechanical intestinal obstruction may cause bowel sounds, in conjunction with abdominal pain, cramping, constipation, abdominal distention, inability to pass gas, etc. Mechanical obstruction of the intestine can be caused by the formation of scar tissues after surgery, hernias, formation of gallstones, impacted stool, and tumors.
Irritable Bowel Syndrome
Irritable bowel syndrome is a type of disorder, that affects the large intestine and produces symptoms like, abdominal pain and cramping, bloating, constipation/diarrhea, flatulence, and loud bowel sounds.
This condition impairs the proper absorption of foods, by damaging the lining of the small intestine. The condition is often triggered by the consumption of foods containing gluten. When gluten containing foods are consumed, the immune system reacts by damaging the villi of the small intestine, which are concerned with the absorption of nutrients. The symptoms that can be produced by this condition are gas and bloating, abdominal pain, constipation/diarrhea, abdominal sounds, nausea and vomiting, and weight loss.
A few other causes of increased bowel sounds include, incomplete digestion of foods, and consumption of high-fiber foods, leading to excess gas formation in the intestine.
When to Call a Doctor
Be sure to seek immediate medical attention, if you experience abnormal bowel sounds along with the following conditions:
- Persistent diarrhea or constipation
- Bleeding from the rectum
Diagnosis and Treatment
Doctors usually determine whether a patient has increased bowel sounds, by using a stethoscope and then carrying out a detailed clinical evaluation. If required, abdominal X-ray, blood tests, and CT scan of the abdomen, are also carried out to find out the underlying causes. Sometimes, endoscopy may also be required to diagnose this condition.
Treatment for abnormal bowel sounds will be determined by the underlying causes. If it is caused by Crohn's disease and ulcerative colitis, then anti-inflammatory drugs, immune system suppressors, antibiotics, and some supplements can be required to treat these conditions. However, the treatment options will differ widely, if bowel sounds are caused by other conditions like, diarrhea, gastroenteritis, or food hypersensitivity.
Increased bowel sounds are usually considered to be normal. But, if you are experiencing excessive and regular bowel sounds, then it is better to consult a health care provider.
Disclaimer: This article is for informative purposes only, and should not be considered as a substitute for professional medical advice.